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AMPICILLIN

Disclaimer to the On-line Edition

This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

AMPICILLIN

Indication

ampicillin is indicated for the treatment of suspected or documented infections caused by susceptible organisms

Pharmacology

ampicillin is a semi-synthetic penicillin with an extended spectrum; it is bactericidal against the usual penicillin-susceptible Gram-positive organisms (incl. group B streptococcus, Listeria monocytogenes, most strains of enterococci) and many common Gram-negative organisms (incl. Proteus mirabilis, many strains of E. coli, Salmonellae and Shigellae, most strains of Neisseria meningitidis and nonpenicillinase - producing N.gonorrhoeae, many strains of Haemophilus influenzae)

ampicillin works similar to other penicillins, ie. inhibition of bacterial cell wall synthesis

ampicillin is most often given in combination with an aminoglycoside, partly because of in vitro and animal studies that indicate a synergistic bactericidal effect

Side Effects

in adults the major adverse effects associated with ampicillin are hypersensitivity reactions and an "ampicillin rash"; in general, however, ampicillin is very well tolerated by neonates

there is the possibility that seizures can occur if serum levels become too high or if the drug is administered too quickly

phlebitis has been reported only rarely following IV administration

Dose

Standard dose: 50 mg/kg IV q12h

Meningitis: 100 mg/kg IV q12h

For UTI Prophylaxis: 50 mg/kg/day

in severe renal dysfunction decrease dose by 50%

incompatible with TPN and lipid

administer via IV push over 3 to 5 minutes or by slow IV infusion

Supplied

250 mg vial

reconstitute with 5 mL sterile water for injection to produce a final concentration of 50 mg/mL; (this concentration is approximately isotonic) this solution must be used within one hour after reconstitution

in volume restricted infants, a concentration of 100 mg/mL may be used after reconstitution

(100 mg/mL concentration is to be used for CENTRAL-LINE delivery only)(1)